Experience report Clinic Nepal – February/March 2023

As a family for three weeks in Meghauli: Marga (general practitioner) and Gerrit (surgeon) report on their assignment at the clinic.

Our time in the Clinic Nepal project in Meghauli, February 2023

From the end of February to the beginning of March 2023 we were in the Clinic Nepal project here in Meghauli as a family for 3 weeks. We are Marga (general practitioner), Gerrit (surgeon), Elsa (9 years) and Mattis (11 years). As part of a long journey that is to take us around the world, we had planned to stop here. We had already met Hari in Freiburg, where we lived until our trip.

From the very first moment we were welcomed very warmly in the house of Hari's brother Ram and his wife Sabitri. We were cooked for in the finest way, and Sabitri always had an eye on our wellbeing, our Nepali vocabulary and on the children when they were not with us at the clinic. For our children it was wonderful to be in a sheltered home, and little by little, through the scout group or the evening football on the large area of the local landing strip, they also got to know the children of the village. Of all the many ideas and projects that Hari has brought to life here with great care, perseverance, energy and vision, we mainly got to know the clinic, the kindergarten and the scout group. Experiencing the kindergarten was a true joy. A great bustle of small children who very quickly gained trust across all language barriers. There is the little boy who, new to the kindergarten, chose our daughter Elsa's lap to face this new world. Or the two girlfriends who proudly showed off all their Lego towers. And all the other (up to 60!) children, among them the four warm-hearted educators, who wonderfully understood how to bring order into the throng. Again and again on our journey we have the wonderful realisation: children, in all their diversity, are the same all over the world! They play, they scuffle and quarrel, they laugh, they love sweets, are curious, open and cry when it hurts.

What surprised us was that lessons already take place in the kindergarten, writing and English and in fact also an ‘exam’ before the transition to school. This can certainly be argued about pedagogically, but it seems to be demanded by the parents and was probably not always so. We were able to contribute with a small crafts offer and repair work on the playground, and our presence was always warmly welcomed, whether with or without an offer; simply playing with the children was a good thing for all sides, especially as there is little play material on site. With more pedagogical creativity than we showed, there is certainly plenty of room here to make offers to the children and to bring in new things. In the Friendship Clinic itself we contributed in our capacity as doctors. For this we were in the clinic in the mornings, which was communicated via social media. Gerrit in particular was able to be helpful as a surgeon, as wounds and bone fractures were frequent and there is also an X-ray machine on site that is operated competently. The other clinical pictures were basically comparable to those in a German general practice. Gastritis, headaches, earaches, a lot of orthopaedics and unspecific complaints. Of course we often ran up against the limits of the diagnostic possibilities; for example, we were repeatedly made aware of the missing ultrasound machine, which has been in repair for some time. Until now it was probably used mainly gynaecologically. And the whole population would also benefit from health education, with tooth decay as a widespread disease and rapidly increasing lifestyle diseases such as diabetes and hypertension. The clinic offers check-ups for this (blood pressure and blood sugar), which, however, are only taken up irregularly in part; an HbA1c is only available in Bharatpur. We were in the clinic in the mornings, as the afternoons were mostly covered by the visiting doctors from Bharatpur. Some mornings were very quiet, others a bit busier, but there was a real rush only at the long-known times of the visiting doctors.

Throughout we had the great team of the clinic at our side, above all Sumon and Sudip. Sumon was the contact person for all questions, and Sudip not only translated for us, carried out the laboratory tests and took the X-ray images, but also explained the cultural aspects. For example, that here a good doctor must always give different patients different painkillers, not all the same one; that it is important to send something with them, even if it is only a vitamin preparation; or that some patients come with ‘complaints’ but actually just want to be examined. Screening of the kindergarten and school children: With the help of the clinic team we carried out a screening examination on all the children in the kindergarten, and we examined the pupils of a nearby school in a problem-oriented way. The most frequent findings were partly advanced tooth decay and blocked ear canals with a mixture of ash, dust and cerumen. Both known problems, the latter at least easily solved with special softening drops and a lot of rinsing; the teeth were always just extracted by the dentist who comes to the clinic on Saturdays – milk teeth or permanent teeth – a wonder that there are still adults here with their own teeth. It was nice to see that the great majority of children are healthy. And then there were the few children whom we would gladly have helped better than their family's circumstances make possible.

Health camp for women in Chenauli

Once we took part in a health camp for women, in which the main aim was to carry out free screening for cervical cancer (110 women were examined) and to solve gynaecological problems. With the help of the acetic acid test we ‘fished out’ at least 4 women, who were then referred on to the Cancer Clinic in Bharatpur. The nurses who carried out the screening were very experienced, and so after a short introduction Marga was quickly able to help and also learn a few things right away. Abnormalities of the cervix or vagina were then shown to the gynaecologist working in the next room. It was astonishing with what patience the women waited all day in good spirits outside the door for their own, so brief, examination. What Hari has created for this community here is simply great. Improving living conditions, advancing education and above all showing young people options – he has achieved this here with a great deal of heart and dedication. We felt very much at home here with the Bhandary family, but also in the whole village, and cannot thank you enough. Because for all the knowledge and time we brought along, we were given even more in return. The children, when they were taken into the football team in the evening by the big boys or could be part of the scouts, all of us through so many people who met us openly, curiously and hospitably.